Low cortisol levels and steroids

If insufficient cortisol is present and the person tested responds to an ACTH stimulation test, then the problem is likely due to insufficient ACTH production by the pituitary. If the person does not respond to the ACTH stimulation test, then it is more likely that the problem is based in the adrenal glands. If the adrenal glands are underactive, due to pituitary dysfunction and/or insufficient ACTH production, then the person is said to have secondary adrenal insufficiency . If decreased cortisol production is due to adrenal damage, then the person is said to have primary adrenal insufficiency or Addison disease .

I was under prolonged stress about a year ago for several months. My body hasn’t recovered. I am showing all signs of low cortisol and adrenal problems but recently got the following results:
In August cortisol levels were at at 8am. 3 months later i had an ACTH test done. At 8 am (before the cortrosyn) my cortisol level was at 12 and 1 hour after the cortrosyn shot it jumped to 22. Dr said this indicates my adrenals are working properly and had no idea why my 8am levels changed so drastically in 3 months. In the meantime, I still feel the same. Any thoughts?

Early symptoms are generic and can be easily confused with other disorders, specifically, fatigue, headache, weakness, dizziness and orthostatic hypotension (low blood pressure upon standing). Nausea, vomiting, and diarrhea are often present as well as an inability to tolerate cold temperatures. Left untreated, the symptoms progress into muscle weakness, weight loss, dehydration, hypotension, irritability and depression. Ultimately, pain in the abdomen, back or legs, collapse of the peripheral blood vessels and extreme weakness would all indicate adrenal crisis.

When activated macrophages start to secrete IL-1, which synergistically with CRH increases ACTH, [10] T-cells also secrete glucosteroid response modifying factor (GRMF), as well as IL-1; both increase the amount of cortisol required to inhibit almost all the immune cells. [11] Immune cells then assume their own regulation, but at a higher cortisol setpoint. The increase in cortisol in diarrheic calves is minimal over healthy calves, however, and falls over time. [58] The cells do not lose all their fight-or-flight override because of interleukin-1's synergism with CRH. Cortisol even has a negative feedback effect on interleukin-1 [10] —especially useful to treat diseases that force the hypothalamus to secrete too much CRH, such as those caused by endotoxic bacteria. The suppressor immune cells are not affected by GRMF, [11] so the immune cells' effective setpoint may be even higher than the setpoint for physiological processes. GRMF affects primarily the liver (rather than the kidneys) for some physiological processes. [59]

Low cortisol levels and steroids

When activated macrophages start to secrete IL-1, which synergistically with CRH increases ACTH, [10] T-cells also secrete glucosteroid response modifying factor (GRMF), as well as IL-1; both increase the amount of cortisol required to inhibit almost all the immune cells. [11] Immune cells then assume their own regulation, but at a higher cortisol setpoint. The increase in cortisol in diarrheic calves is minimal over healthy calves, however, and falls over time. [58] The cells do not lose all their fight-or-flight override because of interleukin-1's synergism with CRH. Cortisol even has a negative feedback effect on interleukin-1 [10] —especially useful to treat diseases that force the hypothalamus to secrete too much CRH, such as those caused by endotoxic bacteria. The suppressor immune cells are not affected by GRMF, [11] so the immune cells' effective setpoint may be even higher than the setpoint for physiological processes. GRMF affects primarily the liver (rather than the kidneys) for some physiological processes. [59]